A patient unbuttoning her shirt in front of an interviewing nurse or inappropriately touching a physician would be viewed as behavior from what stage of mania?

Hearing music in the distance, spending $3,000.00 on halloween decorations on Ebay in one night, and theorizing that the universe is held together by invisible spiderwebs are hallmark thoughts and behaviors of which stage of mania?

Why is it not a good idea to give bipolar patients only antidepressants (without mood stabilizers)?

A patient with bipolar disorder complains that he is not able to sleep because his thoughts are racing and he feels the need to keep moving his legs. What are the best nursing interventions you could offer the patient? Select three.

1. Offer patient a Unisom sleeping pill.
2. Ensure that the patient's room is kept dimly lit and quiet during night time hours.
3. Offer earplugs and an eye mask.
4. Establish a sleeping and waking routine with predictable night time routines, over a period of several days.
5. Engage the patient in a 30 minute spinning class an hour before bedtime to use up excess energy.

2, 3, 4; these interventions ensure that the patient's environment limits stimuli that would disturb sleep and creates a predictable night time routine that helps facilitate the psychological component of preparedness to sleep (See Disturbed sleep pattern diagnosis in NANDA book for more good interventions)

A patient becomes agitated, aggressive and threatens to throw his belongings at nurses and other patients on the floor. As a nurse, what can you do to de-escalate his behavior? Choose all that apply.
1. Calmly talk to the patient and convince him to do jumping jacks with you.
2. Offer the patient pillows to punch.
3. Argue with him and tell the patient that he has no right to endanger your safety.
4. Leave the room when it becomes imminent that he will throw the chair and seek the help of other staff or family members, then return in a few minutes after it seems he has calmed down.
5. Emphasize expectations of appropriate behavior while at the hospital and the consequences of not meeting those expectations.

1, 2, 4, 5; these are distraction techniques that offer a non-threatening way to deal with the patient's behavior. 4 is a means of safely exiting the scene and gaining help in a non-confrontational way (See Risk for Violence in NANDA book for more intervention ideas)

Your patient has not eaten much for two days. You are worried about their nutrition and want to intervene. What are the best actions you can take? Select all that apply.
1. Make food readily available to the patient as snack boxes, 24 hours a day.
2. Offer familiar, favorite and finger foods often.
3. Make the patient sit alone at mealtimes so you can closely observe their eating habits.
4. Serve food restaurant style (portions predetermined), as opposed to family style (self-serve).
5. Monitor and record patient's food intake only at meal times and not during snack times.

1, 2. Number 4 is not a good answer because this doesn't emphasize the patient's choice and independence. Family style food serving is also associated with increased intake. (See Imbalanced Nutrition, less than body requires in NANDA book)

While you are trying to get a patient's psychosocial history, the patient continually says that he hears the soundtrack to his life playing in the distance, and states, "it's awesome, my life is a movie playing on the Sundance Channel". He also states that he is has been gifted with the ability to fast forward time and create time warps. How do you respond to his behavior? Select all that apply.
1. "You may be hearing music but I don't hear any music. We are in a room that is quiet."
2. "What do you mean you hear music? What is it like? Is Def Leppard playing? Are the musicians singing about you?"
3. "Tell me when you started to feel this way, that your life was a movie playing on the Sundance Channel.
4. "I understand that you think you have these special powers, but I need to continue to ask you questions. Please help me answer them."
5. "You can't fast forward time. I dare you to do that right now."

1,3,4; these use therapeutic communication techniques to set boundaries, present reality in a non-confrontational way and not challenge his delusions

What are some key characteristics of the prodromal phase of schizophrenia?

Identify the schizophrenia type by the description:
Symptoms set in at or under 25 yrs, patient has poor personal hygiene and repeats words or phrases often, is difficult to communicate with; the patient may have strange physical habits, like constantly pulling on earlobes or hand clapping.

Identify the schizophrenia type by the description of behavior:
Patient moves very slowly, rarely speaks if at all, voids all over themselves, and when walking to the day room will sometimes "freeze" in place for an extended period of time.

Symptoms of this disorder last at least one day but less than one month and are usually sudden onset that may or may not be preceded by a psychosocial stressor. Name this disorder!

How is schizophreniform disorder different from schizophrenia? (hint: think duration)

Symptoms of schizophrenia that correlate to the stages of schizophrenia last for at least one month but less than 6 months. The diagnosis changes to schizophrenia when the patient has had the symptoms for more than 6 months.

What of the following are classified as negative symptoms of schizophrenia? Select all that apply.
1. Laughing at a funeral
2. Bad breath and foul odor from body because of lack of personal hygiene
3. Pacing the halls and rocking in a chair
4. Not speaking (mutism)
5. Paranoia that there are "bugs in the ceiling"

What nursing diagnosis would you assign to the following behaviors? Withdrawal, sad affect, preoccupation with own thoughts, and expressions of feeling alone or rejected.

If a client is highly suspicious, which of the following can you do to promote trust?
1. Use the same staff as much as possible
2. Touch the client to reassure them.
3. Provide canned food with a can opener and serve foods family style.
4. Play competitive games like Monopoly or Scrabble.
5. Maintain a friendly, cheerful attitude.

A short term goal for the nursing diagnosis of Disturbed Sensory Perception: Auditory/Visual would be: (select one)
1. The patient will discuss the content of the hallucinations with the nurse within one week.
2. The patient will be able to define and test reality.
3. The patient will verbalize the understanding that the voices are a result of his or her illness and demonstrate ways to interrupt the hallucination.

1. The patient will discuss the content of the hallucinations with the nurse within one week.